Mindfulness:
Mindfulness has become something of a buzzword in recent decades; often misrepresented or misunderstood, it’s not surprising that people’s reactions to it can range from cynicism to enthusiasm, and all too often a degree of confusion or uncertainty. Let’s begin by being clear that mindfulness and meditation are not synonyms; they can’t be used interchangeably. ‘Mindfulness meditation’ is one type of meditation practice, there are many others, so you could meditate all life long and never practice mindfulness. Equally, it’s possible to practice mindfulness without ever meditating. But mindfulness meditations just happen to be very effective ways of developing ‘mindfulness’ as a mental state (at least for most people, most of the time). Unfortunately ‘mindfulness meditation’ is a bit of a mouthful, leading people to frequently use one word to mean the whole concept, which only adds to confusion.
I’ve often found that when people ask me what mindfulness is, the question they really want to ask is not ‘what is it’ but ‘why do it’?
So let’s consider that question first:
Mindfulness meditation may well be the best tool we can use to learn how our minds work, and from doing this, we can learn to work more skilfully with the content of our minds. This really matters, as the quality of our mind in any moment really determines our experience of that moment, and how we’re likely to act in the next moment, and thus impacting our relationships and our future experiences too.
So from this, it’s important to recognise that it’s not a way of controlling the mind, or a way of emptying it of thoughts, nor is it a way to avoid or get rid of difficult feelings or urges.
A variety of benefits tend to arise from developing a mindfulness practice, and these are really best thought of as by-products, as the intention of the practice is not to make changes happen; yet paradoxically change is likely to occur nonetheless. This simple paradox can be quite a challenge at times! It’s all too easy to fall into the trap of striving to fix, or make ‘something’ change, whereas the change we’re cultivating is the development of openness, curiosity and kindness towards experience, including that ‘something’…
Significantly, there aren’t different ‘types’ of mindfulness for helping with different issues, such as pain, anxiety, depression, insomnia, stress, etc., although people often imagine that there are, simply because of the way mindfulness is packaged up and offered as a fix for so many difficulties. Instead there are simply mindfulness practices, which, when engaged with skilfully, tend to bring about changes which can be both psychological and physiological. Examples include:
Developing the ability to respond skilfully to whatever we encounter, rather than reacting automatically.
A greater awareness of what is going on in the moment, both on the inside; our thoughts, feelings and sensations in the body, and in the external world.
The development of compassion, including self-compassion and self-acceptance, with the potential for a corresponding reduction in harsh self-criticism.
Greater feelings of well-being and positive mood.
The ability to acknowledge & accept emotions, rather than avoiding or struggling with them, and from this starting point, allowing response and change to occur: In this way, not seeking change may bring about a change in our experience.
Noticing the mind's tendency towards automatic preferences and judgements, and so enabling greater choice to come from this awareness, rather than simply being limited to habitual patterns of behaviours and reflexive reactions.
Studies have shown physical changes such as positive alterations to brain structure, including increases in grey matter in regions where self-regulation, decision-making and self-control develop, or reductions in signs of brain ageing in long-term meditators. Some studies have also shown improvements in immune system response following an 8-week course.
A simple explanation for the mechanism of some of these changes can be found in neuroplasticity: The brain’s ability to grow and change depending upon its use. If we’re dedicating time each day to producing particular patterns of brain use, we can expect to see physical changes in structure, and from this, changes in experience, behaviour, etc.
Of course, mindfulness can be combined with other elements, such as cognitive psychology or compassion practices, and this can enhance the particular benefits of a mindfulness course or program.
And if the ‘what is it?’ question is still there, mindfulness is often defined as being the form of awareness that emerges from intentionally paying attention to our experience, as it unfolds, without judging it, but with interest, curiosity, kindness and acceptance.
This may seem long-winded, but all of those elements are significant, and even this definition is not all encompassing. I’ve read definitions that run to two paragraphs!
Ultimately, mindfulness is best learnt and understood through direct experience, rather than attempting to first understand it intellectually, through reading or hearing about it. Even this poses a challenge; people are so accustomed to being able to learn from books, lectures, documentaries, etc., it can be difficult to accept that practicing is the best way to learn something.
Some of the ways I work with Mindfulness:
Individual teaching:
I offer one-to-one Mindfulness teaching in one-hour sessions, accompanied by a specially developed series of meditation recordings for beginners, which are followed in-between sessions, along with other structured mindfulness practices. Sessions are always tailored to individual requirements, but are loosely structured around the teaching formats of the 8-week group courses. There is no strict schedule, so sessions can be fortnightly or monthly, with plenty of time for personal practice between sessions.
Mindfulness-based courses & group therapies:
I am trained and qualified to teach Mindfulness-based Cognitive Therapy (MBCT), and until the pandemic in 2020 I regularly did so with Mindful Pathway, an organisation based in St. Albans.
Mindfulness really develops through experience, and is ideally suited to learning in a group setting, with plenty of practical experience, and the opportunity to discuss all aspects of this within the group. Even those courses with 'therapy' in the name are quite different from most group therapy situations, as the emphasis is mostly on the mindfulness practice that lies at the heart of the course, supported by one-to-one interactions with teachers.
Research has shown the structure of the MBSR/MBCT courses to be highly effective, lasting 8 weeks, with one session of around two hours per week, and typically a single 'all-day' session towards the end of the course. Participants are usually expected to practice for around 40 minutes per day for the duration, and this is a highly important part of the course: It’s more like a ‘home learning course’ with some required attendance.
Choosing a course or group:
Mindfulness-Based Stress Reduction (MBSR) - This was the first mindfulness-based program, originally developed to help people coping with chronic pain.
Mindfulness-Based Cognitive Therapy (MBCT) - This was developed from the above MBSR course, and shares a great deal of content and structure. The inclusion of some cognitive therapy content is likely to be helpful to people who have experienced depression or anxiety. The program is specifically designed to reduce the risk of relapse or recurrence in depression, and has been shown to be highly effective for people who have experienced three or more bouts of depression.
Both of these courses provide an effective way of discovering mindfulness, and developing a personal mindfulness practice, and both have been extensively employed in research environments.
There are a number of other Mindfulness-based therapies that may involve group work, such as Dialectical Behaviour Therapy (DBT) for the treatment of borderline personality disorder.
Mindfulness-based therapies for individuals:
It's increasingly common to find elements of mindfulness within psychotherapy, but there are still relatively few approaches that are truly mindfulness-based. Acceptance and Commitment Therapy (ACT) is probably the longest established and most well-known, having been developed during the 1980s. It can be classified as a behaviour therapy, however it is radically different in approach to almost every other form of Cognitive Behavioural Therapy (CBT). I work extensively as a psychotherapist using ACT, for more information on this subject, please follow the ACT link in the navigation menu on this page.
Frequently Asked Questions:
Is Mindfulness religion-based or does it involve any spiritual teachings?
Western mindfulness (as outlined above) is entirely secular: It is not connected to any religion, and does not involve any religious or spiritual teaching. This has been an intentional aspect of its development in medical and scientific contexts, enabling it to be accessible to anyone. Many of the practices have origins in contemplative traditions, particularly Buddhist traditions, although meditation practices stretch back thousands of years before the life of the Buddha, and can be found in a wide range of religious traditions.
Is Mindfulness meditation relaxing?
It certainly can be, and many people do find meditation makes them feel relaxed. However, relaxing is not the intention, and there may be times when it is not relaxing. This is one reason why it can be unhelpful to use mindfulness meditation as a way to relax: If it stops being relaxing, you're likely to stop practicing. Equally, if the intention of practice becomes relaxation, this is in direct opposition to the mindful intention to be open, curious and kind towards our experience as it is in the moment; instead insisting that our experience is changed by relaxing.
Do I need to sit in a special way?
Not really, although posture is important for a number of reasons, including your own comfort, and thus guidance on posture is given to groups when they meditate. Groups are most often taught whilst sitting on normal chairs. Quite often, people like to use cushions, stools or benches for their own personal practice. There are some practices which are best done lying down, and others involve standing & moving, so it's not all about sitting!
How often will I need to meditate?
Most courses involve around 40 to 50 minutes of personal practice per day, and it's worth checking what may be expected of participants on a particular course before starting one, as home practice is a very important element, from which many of the benefits of mindfulness arise.
Other approaches to learning mindfulness vary enormously in the amount of time people are invited to practice, but you can expect to find a close link between time spent and degree of benefit. Research suggests the regularity of practice is particularly significant.
Going forwards, maintaining a personal practice will involve deciding what works best for you, as, if it doesn't work for you, you'll probably stop doing it before too long! Most people will maintain a practice because they feel that it benefits them, and many say that they seem to make more effective use of their time after meditating, so they actually feel they have gained time. Some research indicates that regular short meditations are more beneficial than occasional long ones, i.e. 10 or 15 minutes a day, rather than an hour or two at the weekend. Another possibility is to combine both, with short daily meditations, and longer ones at the weekend.
Are mindfulness courses available on the NHS?
Yes, some are (e.g. MBCT), although it will vary from one area to another.
In 2015 an All-Party Parliamentary Group report made a number of health-related recommendations, including that ‘MBCT (Mindfulness-Based Cognitive Therapy) should be commissioned in the NHS in line with NICE guidelines so that it is available to the 580,000 adults each year who will be at risk of recurrent depression’, and that ‘those living with both a long-term physical health condition and a history of recurrent depression should be given access to MBCT, especially those people who do not want to take anti-depressant medication’.
A short history of secular mindfulness in a clinical setting:
Today, the word 'mindfulness' is frequently heard in clinical, therapeutic and research settings, it's also increasingly common in the media and popular culture. So why is there so much interest in it?
In large part, the answer lies in the amount of peer-reviewed scientific research that has been undertaken into mindfulness & mindfulness-based therapies. Starting back in 1979, Jon Kabat-Zinn developed a program which became the 8-week Mindfulness-Based Stress Reduction course (MBSR), which proved highly effective in helping patients experiencing chronic pain, often in cases where other medical interventions had done little to help. Subsequently, MBSR was used as a basis in the development of Mindfulness-Based Cognitive Therapy (MBCT), which has been shown to be the best approach to preventing relapse & recurrence with depression. Today there are a number of different 8-week courses, along with individual therapies based on mindfulness. In addition, mindfulness is beginning to inform interventions within the therapy room, and many therapists are benefiting from developing their own mindfulness practice. The corporate world is also investing time & money in mindfulness training, and seeing benefits that will often result in mindfulness training programs being expanded to include more of the workforce.